From the Loma Linda University Medical Center and Brigham and Women's Hospital.
Plast Reconstr Surg. 2019 Jan;143(1S Management of Surgical Incisions Utilizing Closed-Incision Negative-Pressure Therapy):7S-10S. doi: 10.1097/PRS.0000000000005305.
Postoperative complications such as surgical site infections, dehiscence, seromas, and hematomas prolong wound care and impose significant cost increases to patients and healthcare providers. Clinicians aiming to reduce the incidence of these complications should be aware of risk factors associated with surgical type, procedures used, patient characteristics, and postoperative care. Today, improved guidelines and general practices for managing surgical incisions have reduced the incidence of complications to historic lows. In addition to these standard care options, advanced wound care approaches have been extensively studied and exist as options for clinicians to provide adjunctive postoperative support and facilitate wound healing. These systems include advanced wound dressings and closed-incision negative-pressure therapy. Advanced wound care is not appropriate in all settings, and healthcare providers must assess each case for specific needs to be addressed by the available incision management plans. Emerging therapies that are intended to improve the continuum of postoperative care should continue to be evaluated in controlled clinical trials to determine their effectiveness under different circumstances and to support the creation of more robust guidelines for their use.
术后并发症,如手术部位感染、裂开、血清肿和血肿,会延长伤口护理时间,并给患者和医疗保健提供者带来巨大的成本增加。临床医生如果想要降低这些并发症的发生率,就应该了解与手术类型、使用的程序、患者特征和术后护理相关的风险因素。如今,管理手术切口的改进指南和一般做法已将并发症的发生率降低到历史最低水平。除了这些标准护理选择之外,先进的伤口护理方法已经得到了广泛的研究,并为临床医生提供了附加的术后支持和促进伤口愈合的选择。这些系统包括先进的伤口敷料和封闭切口负压治疗。并非所有情况下都适合采用先进的伤口护理,医疗保健提供者必须根据具体情况评估每个病例,以确定可用的切口管理方案需要解决的具体问题。旨在改善术后护理连续性的新兴疗法应继续在对照临床试验中进行评估,以确定在不同情况下的有效性,并支持制定更有力的使用指南。